How long to wait after chemotherapy and/or radiation for breast reconstruction – pro
Should there be a waiting period between the last chomotherapy treatment and the reconstruction surgery?
Yes.The general standard among breast surgeons is to wait 6-9 months after chemotherapy and radiation is completed. The waiting time period can be shorter if only chemotherapy had been given and many palstic surgeons will suffice withe waiting 3 months. The American Cancer Society recommends delaying reconstruction for those who know they will have radiation, which is about half of all patients. In the long run, radiation can permanently affect the skin’s pigment, texture and elasticity, which could affect the appearance of reconstructed breasts.
There is not much clinical study evidence relating to this question. One study finds that about half of women who need radiation therapy after having had a mastectomy with immediate reconstruction develop complications that require additional surgery. Another study finds that chemotherapy does not affect complication rates after mastectomy and immediate reconstruction. It found that chemotherapy, either before or after the mastectomy and immediate reconstruction, had no bearing on complications and the need for more procedures.
Overall, 31% of 163 patients studied (some of whom received chemo, and some who did not) had a complication that required a return trip to the operating room. But the rate didn’t differ based on whether the woman received chemo before surgery, after, or not at all. However, another study found minimally higher complications rate when reconstruction was done soon after chemotherapy.
Kate G Richards, MB BChir, Parto Forouhi; Andrew Johnston; and Charles M Malata, Pre-Operative Thrombotic Complications of Neoadjuvant Chemotherapy for Breast Cancer: Implications For Immediate Breast Reconstruction, K Annals of Medicine and Surgery, Volume 3, Issue 4 (December 2014)
Warren Peled A, Itakura K, Foster RD, Hamolsky D, Tanaka J, Ewing C, Alvarado M, Esserman LJ, Hwang ES. Impact of chemotherapy on postoperative complications after mastectomy and immediate breast reconstruction.Arch Surg. 2010 Sep;145(9):880-5.